Nutrition Considerations in GERD & Acid Reflux Medications

Certain nutrients can interact with the medications you take to treat GERD & Acid Reflux

Gastroesophageal reflux disease (GERD) and acid reflux treatment involves both dietary and lifestyle management and there are times when the use of prescription and/or over-the-counter medications is absolutely medically necessary for those people who suffer from these conditions. But have you ever taken the time to read through all of those lengthy information sheets attached to the medications before? 

There are some drug-nutrient interactions to be aware of with these medications, so if you have any questions about them either before starting them or while taking them, you should always ask your medical provider or pharmacist for further information

Additional Nutrition Considerations in GERD & Acid Reflux Medications

Let’s start by taking a look at the different over the counter and prescription medications that are used and what they are used for. Then, with each category we will look at the potential nutrient considerations to consider with each category. 

Antacids are used to neutralize stomach acid and gastric contents. 

Examples of these medications include, but are not limited to- Alka-Seltzer Effervescent Tablets, Aluminum Hydroxide, Calcium carbonate, Dulcolax, Gas-X with Maalox, Gaviscon, Gelusil, Maalox, Magnesium Oxide, Milk of Magnesia, Rolaids Tablets, Sodium Bicarbonate, Sodium Citrate, and Tums.

  • Are known to destroy thiamin (Vitamin B1- which you can find in many foods such as pork, fortified breakfast cereals and bread)
  • May contain sodium
  • If the antacid contains calcium (such as those made with calcium carbonate such as Alka-Seltzer and Tums), excess calcium may decrease the potassium and magnesium levels in the body
  • If the antacid contains aluminum hydroxide (such as Gaviscon, Mylanta & Gelusil), it may deplete phosphorus in the body 
  • If the antacid contains sodium bicarbonate (such as Alka-Seltzer), it can decrease iron absorption and increase sodium retention

Histamine-2 Blockers (H2 Blockers) are used to decrease gastric acid secretions and are used as an anti-ulcer and anti-GERD medication. 

Examples of these medications include Cimetidine (Tagamet), Famotidine (Pepcid; Zantac 360) & Nizatidine.

  • Can decrease iron absorption
    • If taking iron supplements, it may be recommended that you take these medications at least 2 hours before or after the iron supplement
  • Can decrease Vitamin B12 absorption
  • Magnesium supplements & Aluminum/Magnesium antacids should be taken separately by at least 2 hours since they decrease the absorption of H2 blockers
  • Limit caffeine intake while on these medications

Proton Pump Inhibitors (PPIs) are used to decrease gastric acid secretions and are used as an anti-ulcer and anti-GERD medication. 

Examples of these medications include Dexlansoprazole (Dexilant), Esomeprazole (Nexium), Lansoprazole (Prevacid), Omeprazole (Prilosec; Zegerid), Pantoprazole (Protonix) & Rabeprazole (Aciphex).

  • Can decrease iron absorption
    • If taking iron supplements, it may be recommended that you take these medications at least 2 hours before or after the iron supplement
  • Can decrease Vitamin B12 absorption
  • Some PPIs may decrease calcium absorption (Journal of Pharmacy Technology, 2007)
    • Calcium supplementation may be indicated; Calcium citrate is better absorbed than Calcium carbonate in people on PPIs
  • Some herbal supplements such as Ginkgo Biloba & St. John’s Wort can interfere with the absorption of PPIs and therefore should be avoided
Again, these are just some nutrition considerations with antacids, H2 blockers, and PPIs. It is important to check with your medical provider and pharmacist for a complete list of nutrient-medication interactions and other medication-medication interactions to make sure that you are absorbing and utilizing both your nutrition and your medication to the best of your ability!

Pronsky ZM, Elbe D, Ayoob K. Food medication interactions. 18th edition. Birchrunville (PA): Food Medication Interactions; 2015 Apr 17. 444 p.

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